Low Serotonin and Gastrointestinal Disorders

Written by: Kevin Cann

Serotonin is one of our neurotransmitters that are responsible for our mood. If our serotonin levels fall off we may experience anxiety and depression. More information about serotonin can be found in a previous article I wrote here, http://robbwolf.com/2012/10/05/serotonin-deficiency-food-cravings/. What many people do not understand is that serotonin also plays a role in gastrointestinal disorders. In fact, the majority of our serotonin is produced in the gut, roughly 95%.

Serotonin is produced in the enterochromaffin cells (EC) in the intestinal mucosa. Serotonin is produced, and then it bonds with its receptors. These receptors are known as the 5-hydroxytryptomine receptors, or as they will be referred to here on out as 5-HT receptors. Once the serotonin is released, it activates our system to increase intestinal motility. Research has shown that there is an increase in plasma 5-HT during diarrheal diseases, and a decrease in them when constipation is present (Cammilleri, 2009).

These receptor sites are actually targets for medications when treating diarrhea and nausea. 5-HT (3) receptor antagonists are used during chemotherapy treatment to help alleviate symptoms and 5-HT (4) agonists are used to help treat constipation (Costedio, 2007). Therefore, if we have too little, or too much serotonin floating around we can experience all kinds of common gut issues.

Selective Serotonin Reuptake Inhibitors (SSRIs) are the most commonly prescribed antidepressants. They too work upon the same serotonin pathways to help aid in depression. Common side effects of SSRIs are nausea, diarrhea, and nervousness. All issues associated with improper levels of plasma 5-HT receptors.

The new path of the medical community seems to be leading towards drugs that affect the serotogenic pathways to treat IBS. One such drug is a 5-HT antagonist and it is called Alosetron. In one study, Alosetron showed to be beneficial in treating global IBS symptoms in women with IBS that were experiencing diarrhea symptoms. This was after conventional therapy had failed (Mayer, 2003). Studies have even shown it beneficial in reducing symptoms of anxiety.

On the other end of the spectrum we have IBS with constipation. Treatment for this is leading to medications that act as 5-HT agonists. One of those drugs is Renzapride. Cammilleri and colleagues showed that Renzapride was associated with improvement of bowel function in women (Cammilleri, 2004).

The Understanding of IBS and its roots are still up in there. Chances are it is not just caused from one factor. What we do know is that poor gut health can lead to poor mood and vice versa. Our serotonin pathways may be a large player in this part. Due to this understanding, we want to take action in making sure we have adequate serotonin. We do this by getting proper sleep, having proper vitamin D levels, getting sufficient sunlight, not drinking too much alcohol or coffee, and eating high quality protein. We need to make sure we also have good digestive health. Without proper digestion, the tryptophan and the nutrients required to convert it into serotonin may not be present.

If you are suffering from IBS and dietary changes and conventional therapies are not working, you may want to seek out a qualified health practitioner and have your serotonin levels checked. Simple 5-HTP, or L-tryptophan supplementation may be all you need to help alleviate specific symptoms. The other neurotransmitters may also play a role in IBS as well, and I will discuss those in future articles. The vagus nerve that allows for communication between our gut and our brain is a two way street. Sometimes healing the mind will heal the gut and vice versa. Eat nutrient dense foods and manage your stress, and you will be surprised at how far just those two little things can take you.

Kevin Cann

Kevin is the Director of Strength and Conditioning at Total Performance Sports in Boston, MA. Kevin holds a master’s degree in Kinesiology and a bachelor’s degree in health and wellness with an emphasis in nutrition. He is a certified performance enhancement specialist through NASM. He is currently a student of former Team Russia Powerlifting Coach Boris Sheiko. He works with people of all walks of life from rehab, to weight loss, and to competitive athletes. Check out his site at www.totalperformancesports.com

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Another method of treating this is by considering whether or not fermentable carbohydrates are the issue at hand- particularly the class referred to as FODMAPs. Some studies have shown that restriction of these carbohydrates reduces symptoms of depression- possibly by increasing serum tryptophan levels, which are required for the production of serotonin.http://www.ncbi.nlm.nih.gov/pubmed/11099057http://www.ncbi.nlm.nih.gov/pubmed/10961700

Hopefully more awareness of this will decrease the often unnecessary practice of prescribing side-effect-heavy anti-depressants to patients with IBS with the usually mistaken belief that depression causes IBS instead of the other way around.

It’s interesting that serotonin also plays a role in platelet aggregation and other aspects of inflammation. It’s a multi-purpose molecule, not just a neurotransmitter, and this may complicate treatment of the depression-as-inflammation model.
Serotonin levels can be adjusted with niacinamide without adding extra tryptophan into the system, as conversion to NADH is a tryptophan degredation pathway.

A word of caution on 5-HTP: while I had good results in terms of sleep quality and reducing cravings, I also experienced increased GI distress. Fortunately, I eventually noticed the warning on the bottle that people with GI disorders should not use 5-HTP. So, in this context, 5-HTP isn’t a great recommendation.

I’m looking forward to your future posts on GI and neurotransmitters. Would definitely like to see a post on increasing serotonin without supplements.

this is very interesting. i have ulcerative colitis and i’ve been looking into wellbutrin for my symptoms. i’ve read that it’s a tnf inhibitor but not sure what it does for serotonin levels. anyone know?

Wellbutrin is a MAOI inhibitor. Not too too familiar with it, but there are two types MAO-A and MAO-B. MAO-A stops the breakdown of serotonin, norepinephrine, and dopamine. MAO-B stops the breakdown of dopamine.

It doesn’t look like Wellbutrin is a proper MAOI (though plenty of chemicals like this have a weak competitive action). It’s more like an amphetamine. Wiki says “Its primary pharmacological action is thought to be norepinephrine-dopamine reuptake inhibition. It binds selectively to the dopamine transporter, but its behavioural effects have often been attributed to its inhibition of norepinephrine reuptake.”
There are no gut effects listed. http://en.wikipedia.org/wiki/Bupropion

Some years ago due to some drastic changes in my life I started to inquire into myself and found out that I was not as happy a person as I thought myself to be. Months of soul-searching, but little did help me to find my happiness. Then someone introduced meditation to me. I meditated on a regular basis for over a year but still despite it was confused, disappointed and angry inside. Constant moodiness was a normal state of being at the time and nothing or no one seemed to be able to alleviate it.

Then a friend invited me to a ceremony with a shaman from Latin America. He told me that a certain psychedelic mushroom will be used. I was curious and agreed to participate. For some two weeks after the ceremony I was on top of the world. Then many more ceremonies followed in the course of two years and I can say, believe it or not, these helped me more than anything else to find myself and be more happy. These days I wake up with a smile…

Also, I agree with you that vitamin D, sunlight, sufficient sleep, a healthy diet and I’d add plenty of exercise I am sure are able to boost serotonin levels. I vote for regular exercise, plenty of sleep and a good diet as these too no doubt helped me to cure myself…

Wellbutrin saved me by getting my digestive system going again. I was at risk of starvation because I could not get satiated or gain weight by eating every waking hour! Upper GI, colonoscopy, urinalysis, blood analysis, and ultrasound found no explanation. But over night Wellbutrin XL 150 mg fixed my problem. For the past two years I have eaten three meals a day, get hungry only 30 minutes before each meal, and can gain or loose weight at will by choosing my balanced diet or a low carb diet. Wellbutrin (Bupropion) appears to have facilitated restoration of digestive messages that weren’t getting through. After a decline over 4 to 5 years I have received about a 95 or 98 percent restoration of my digestive system effectiveness. I’ve tried weaning off but the problem returned after 4 to 5 weeks without Wellbutrin. I am a 57 year old male with MDD for about 2.5 years. I also use Latuda to control the MDD.

I have had pan colitis for some years, dreadful disease. Medication, Pentasa/Mesren/Asacol has some wicked side effects. It turns out the enteric coating used is damaging reproductive hormones and other essential steroids. In my case, permanent. I have used, instead of medication, for over 2 years, high dose vit d3 oil capsules, 40,000IU 1st 18 months, then gradually down to now 10,000 IU, very good inflammation control, but not a cure. I also use high dose DHEA, now 400mgs daily, very good results, especially bowel mucous, fatigue and cough, brilliant.
I have been using 3,000mgs at bedtime, L-Tryptophan tablets (amino acid), makes a noticeable difference, i,ve just changed to L-Tryptophan powder, again, 3gms, incredible, irratable bowel, GONE, next day!
I have to assume powder is easier absorbed, plus it’s much cheaper, USA supply via Ebay, must be pharmaceutical grade. I suspect, a cure!
If you are interested in herbal, look at Shatavari, interesting, and controlling. Good Luck.

I have suffered for about 8 years…with ibsc. Debilitating…and all I needed was one capsule of tryptophane to be almost normal in one day!!!??? It has taken me years to find the missing link!
I with mago7 and 1 capsule of tryptophane I am almost normal. Why do docs not know this??? Miralax, stool softners….really? What a joke! I due to all of these problems went gluten and dairy free 4 years ago…natural calm worked for a while then stopped…I now take mago7. With the tryptophan I can most likely go back to the calm which is easier to take. I have also read that it takes both to work together for ibsc, mag. and tryptophane. Maybe the glysophate in all the food initiated all of this junk…but I knew there was some missing link…and I believe this is it… persistence, pain, money,dumbos,time…..finally a simple missing link that makes total sense. People need to know this…maybe all reflux issues, ibs, ect. could be gone. But genetically modified foods and meats with antibiotics are not going either, nor the dairy problems. If you want to be well, an SSRI is not gonna help! U gotta eat and drink clean, and watch out for all the scammers. Today I finally feel for me…that my missing link was the tryptophane that breaks down to serotonin which needs magnesium to work the bowels correctly. I refuse to take linzess, or an SSRI. Well enough of my babble… I sure hope it helps someone!
Cheri

My 12 year old son is suffering from digestive issues and is experiencing anxiety and the doctor wants to put him on Zoloft. I am not against medicine at all, but I feel like in this case I need to start with his digestive issue first and see if this is the underlying issue of it all. Does the serotonin level in his gut have anything to do with the serotonin level in his brain? If so how can I fix naturally?

I use Young Living’s NingXia Red juice (2oz/day) and the Essentialzyme and the Essentialzymes-4 (when I’m on the go). Those work for me. I’m going to try the Sulfurzyme too because of the MSM as I have bad joints also. I get it from a doctor at work; her number is #3151412. You have to have a number to order.

Hello again,
Just read Teresa D’s comments.
seratonin is produced in the gut, incredibly 95% of it. Look it up, tryptophan and seratonin ,linked to Crohn’s and Colitis plus other digestive and IBS problems. Yes, its likely that seratonin deficiency is linked to poor digestion of-tryptophan, is an essential amino acid, basically what we get in protein,so supplementing tryptophan can only help with anxiety, (precurser to seratonin) and being effectively a food supplement, pretty harmless. Sadly, if we ask a doctor, they will probably prescribe an SSRI, a selective seratonin reuptake inhibitor. If it was my child, i know what i would choose, one’s a drug, very clever but very invasive, the other a food You could get the child checked for wheat intolerance, just in case. Tryptophan is quite easy to get online, i use Vita Nutri, pharmaceutical quality and excellent service from USA. Ordered mine, Wednesday, via Ebay, (Nutri Vita), received Saturday, incredible. Plus brilliant results..Good luck.
Richard

ROBB WOLF, author of The Paleo Solution, is a former research biochemist and one of the world’s leading experts in Paleolithic nutrition. Wolf has transformed the lives of tens of thousands of people around the world via his top ranked iTunes podcast and wildly popular seminar series.